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Study: Breast Cancer Strikes Hard at Young Blacks

ED GORDON, host:

I'm Ed Gordon and this is NEWS AND NOTES.

Few African-American women under 50 get breast cancer, but when they do it's often more serious and requires aggressive treatment. Black women are far more likely to die than white patients the same age.

Now, some researchers from the University of North Carolina at Chapel Hill say they may know why this is the case.

Rose Hoban reports from North Carolina Public Radio.

ROSE HOBAN reporting:

Last summer, Lorie Williams got an unwelcome surprise when she found a lump in her right breast. She started calling doctors' offices for appointments and got the same reaction over and over.

Ms. LORIE WILLIAMS (Breast Cancer Survivor): Oh, you're pretty young!

HOBAN: At the time, Williams was 29 years old. She was persistent. It took her several rounds of calls to reach the doctor to finally get a mammogram appointment. Along the way, she had to fight the perception that women only start getting breast cancer once they're older. When Williams was diagnosed, even she had a hard time believing it.

Ms. WILLIAMS: I remember, you know, feeling in the beginning like - I just felt like, oh, I'm too young for this. And I remember I felt like I was going to die. I felt like this is a death sentence. I mean, who's 29 years old and gets breast cancer? That's unheard off, you know.

HOBAN: The lump Williams discovered doing her self breast exam turned out to be an inch and a half wide tumor that had spread in her breast. She ended up at UNC's Lineberger Cancer Center, where she needed some pretty aggressive treatment.

Ms. WILLIAMS: I had eight sessions of chemotherapy. And I had - I can't remember the approximate number of radiation treatments, but it was like 60-something, because it was everyday for March, April - so like, two and a half months every day. And I had surgery January 27.

HOBAN: Williams is young to be diagnosed with breast cancer. The vast majority of women who get it are 50 and older. Some women under 50 get the disease, but not all breast cancers are equal.

Dr. LISA CAREY (Associate Professor of Medicine, Hematology-Oncology Division, UNC's School of Medicine): You know, we call breast cancer one name, but in fact, it's not one disease, it's a whole family of diseases.

HOBAN: Lisa Carey is a doctor at the Lineberger Cancer Center.

Dr. CAREY: Each of those diseases within the umbrella of breast cancer acts differently.

HOBAN: In addition to treating patients, Carey does research. She's the lead author of a study that appears in The Journal of the American Medical Association.

Dr. CAREY: This particular study was born of asking a question about the different breast cancer subtypes, now that we know there are different breast cancer subtypes, and trying to figure out how common they were in a regular population of breast cancer patients, because we really didn't know.

HOBAN: What Carey and her team found was that black women who haven't gone through menopause yet are more likely to get basal-type breast cancer. It's a more aggressive cancer subtype.

Dr. CAREY: Thirty-nine percent of the pre-menopausal, African-American women -if they get breast cancer, 39 percent of the time, it's going to be one of this angry kind of breast cancer, compared to only 15 percent in older African-American women or Caucasian women of any age.

HOBAN: Carey says one of the problems with the basal-type cancer is how quickly it grows and spreads. It's also very difficult to treat.

Dr. CAREY: Even the lowest risk cancer has a chance of coming back a year later, two years later, five years later. I mean, we all know those stories of, you know, oh, Ms. Jones, she was fine. She had her lumpectomy five years ago. Now it's come back in her liver. That's what breast cancer does.

HOBAN: Carey says this might be part of the reason why young black women with breast cancer have a 77 percent higher mortality rate than young white women. And for several decades, researchers have been able to quantify how African-American women have a harder time getting screened and getting treatment for the disease to begin with.

Paul Godley is another oncologist at UNC. He also leads a program that studies the disparities that exist in healthcare.

Dr. PAUL GODLEY (Medical Oncologist, UNC Lineberger Cancer Center): What this study does is it reveals a mechanism by which an aggressive tumor can be expressed more in African-American women and lead, potentially, to worse outcomes.

HOBAN: Godley says it's important to know that African-American women get more aggressive tumors. He also says difference in tumor type probably isn't the only explanation for the high death rate among black women with breast cancer.

Dr. GODLEY: My own interest is that a lot of these issues, particularly the ones surrounding race that we continue to sort of sort out and communicate about, how to use these, how not to stigmatize people, and how not to ignore all the other things that go on in the healthcare system that affect people's outcomes.

HOBAN: Godley and Carey say the next step for researchers is to find ways for clinicians to easily identify the kinds of tumors patients have so aggressive treatment can start sooner. And they say it's important to be as aggressive in ensuring access to care and treatment.

For NPR News, I'm Rose Hoban. Transcript provided by NPR, Copyright NPR.

Rose Hoban